The urodynamic aspects of the Guillain-Barré syndrome.

A total of 7 patients with the Guillain-Barré syndrome and voiding dysfunction, large post-voiding residuals or urinary retention underwent urodynamic evaluation. Of the patients 4 had detrusor areflexia with a positive bethanechol supersensitivity test, including 3 with electromyographic evidence suggestive of neuropathy. This is the expected pattern in the Guillain-Barré syndrome. However, 3 patients had detrusor hyperreflexia with appropriate sphincteric relaxation, which was associated with Babinski's sign in 2. The presence of detrusor hyperreflexia suggests the possibility of Guillain-Barré pathological conditions involving the central nervous system, although the Guillain-Barré syndrome typically is a disease of the peripheral nervous system. Long-term urodynamic studies may help clarify such issues in future patients.